A physician who owned and operated a pain management clinic in Maryland has been sentenced to 9 years in prison for a $3 million healthcare fraud scheme.
The initiative will include up to 5,000 practices in 20 regions, which would encompass more than 20,000 doctors and clinicians. It's the agency's largest plan ever to transform and improve how primary care is delivered and reimbursed.
A report from the Center for American Progress highlights several state-level programs that have reduced costs while maintaining or improving quality.
This month, hundreds of hospitals across the country started doing hip and knee replacements under Medicare's mandatory bundled-payment initiative. Experts say many weren't ready to meet the tough challenges, but at least two have rigorously prepared themselves.
Sixty-seven metro areas in Medicare's joint replacement bundled payment, ranked by joint replacement cost above regional averages. Sources: CMS Innovation Center, Modern Healthcare reporting. Published April 11, 2016, p. 34.
State Medicaid agencies have launched a wide array of payment and care-delivery reforms, some of which go further than the federal government's efforts. While they offer the promise of delivering higher-quality care, it's unreasonable to expect them to deliver lower costs, at least in the short run.
A second troubled government-run hospital on a Native American reservation in South Dakota was given an extension Friday to reach an agreement with federal officials to make significant quality-of-care improvements to avoid losing its Medicare and Medicaid funds.
A Texas jury sided with Abbott Laboratories in a decadelong Medicare fraud case Thursday that could have cost the company as much as $1 billion.
Did the Obama administration indulge health insurance companies with friendly changes to Medicare Advantage rate policies for 2017? Or did CMS officials stick to their guns on proposals the industry aggressively lobbied to kill? Experts say it was a little of both.
The CMS has awarded defense contractor Northrop Grumman Corp. a $91 million contract to develop and implement a second generation of an advanced analytics system to help identify high-risk claims in Medicaid and Medicare.
The Medicare Payment Advisory Commission has completed work on a road map for overhauling how the program pays for post-acute care. The advisory panel voted to back a variety of changes to the Part D prescription drug program that could save as much as $10 billion over five years.
Major healthcare systems are generally praising the CMS' attempts to make Medicare's biggest accountable care program more attractive as the agency strives to grow the number of participants while also persuading more of them to assume greater financial risk.